Provider Demographics
NPI:1548618739
Name:DAVIS, SARAH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WOODBURY GLASSBORO RD STE 26
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3738
Mailing Address - Country:US
Mailing Address - Phone:856-589-3708
Mailing Address - Fax:856-589-2662
Practice Address - Street 1:660 WOODBURY GLASSBORO RD STE 26
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-3738
Practice Address - Country:US
Practice Address - Phone:856-589-3708
Practice Address - Fax:856-589-2662
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10507900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine